Good Will Hunting

May 20, 2011

Why Therapists Want to Talk about Your Childhood

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Why do we have to talk about my childhood? Shouldn’t I be over that? What difference does that make now?

Sometimes, it makes all the difference.

Not everyone requires an in-depth therapeutic look at their childhood. Many people can benefit from short-term treatment to get over a crisis, a recent loss, or current relationship issues.

Others will profit from a cognitive-behavioral approach (CBT) that works to change present day action, thought, and emotion.

But there are times when the past is a dead-weight on one’s life, preventing any kind of lift-off into a more productive, joyous, lofty, airborne, less anxious and guilty way of being; one that is not grounded by a gravity — an invisible force — that seems to pull one back to a repetitive cycle of sadness, regret, and chronic avoidance of challenges.

An example:

Take an intelligent young woman in her 20s — movie-star beautiful — with a quirky sense of humor, and more than average intelligence. Her parents praised only her beauty, but derided everything else about her. From an early time their constant criticism made her worried about displeasing friends; and later on, lovers.

She learned that she could make a dazzling first impression while hiding her anticipation that others would find out what she offered was only skin deep.

This woman’s super-model exterior and surface gaiety belied her belief that there was nothing inside of her that was really valuable. She hid the thoughts and feelings that her parents had always put down, so as to prevent people from discovering her vulnerabilities.

But even when she was successful at “fooling them into thinking” that she was better than she really was, the praise and approval she received only persuaded her that she was a good actress — that beneath the stage makeup she was nothing — just nothing but an empty, worthless shell.

Her anxiety about being “exposed” for the fraud she felt herself to be was combined with a depression that grew out of her failure to win her parents’ love. And, in order to achieve that love, she continued to try to extend herself and prove herself to them, only to be rejected or neglected or taken advantage of once again, thus confirming her sense of worthlessness.

Unfortunately, she was also drawn to potential boyfriends and platonic companions who resembled her parents in their mistreatment of her — as if the only love worth having was one that would allow her to triumph over rejection and win the affection of someone who resembled her parents in their lack of affection for her.

Our heroine succeeded in graduating from college and getting a good job. But none of this filled her up more than temporarily, just as a new purchase of an attractive dress might make her feel good for a few hours or days until she sank back into her default state of sadness and misgiving.

Now imagine that you are her therapist. What would you do?

Tell her that she is beautiful, talented, and accomplished (as evidenced by her academic and vocational success)?

She has already tried to tell herself this, she has already heard this from others, and she still feels bad.

Work with her to improve her social skills?

She is already skilled socially; “a good actress,” as she would characterize it. She is able to be assertive professionally and put-up a good front; until, of course, it involves a personal relationship about which she feels strongly.

Send her to a psychiatrist for anti-depressant or anti-anxiety medication.

Perhaps, but this does not guarantee that she won’t continue to have the same self-doubts and make the same bad relationship choices of people who treat her poorly.

Use Cognitive Behavioral Therapy (CBT) to help her “talk back” to her negative self-attributions (put-downs of herself) and help her to evaluate herself more objectively.

This is not likely to be sufficiently helpful by itself if she continues to favor people who reject her, caught in some version of the old Groucho Marx joke: “I wouldn’t want to be a member of any club that would have me as a member.”

Use CBT to help her gradually stand-up to the people who are treating her badly.

Again, this might be somewhat useful, but will be countered by her belief that there is something wrong with her, and that she deserves the mistreatment she receives. Moreover, it will be hard to be assertive because of her terror that she will lose these same people if she pushes back against them.

What then is left?

In my opinion, this lovely young woman will have to begin to see (really see) and feel what has happened in her life, going back as far as necessary to the mistreatment she received at the hands of her parents: their failure to give more than lip-service to loving her, their cruelty, their inattention when she did something that should have been praised, their criticism, and their tendency to make her feel deficient and guilty.

If she does not see them for who they are, she is likely to continue to believe that it was largely her own inadequacy that caused her to fail in her quest for their love. And, if she continues to place them even on a relatively low pedestal, she will also keep reaching out for love from all the wrong people — the people who remind her of those parents; those who possess the only kind of love she wants because it is unconsciously associated with her parents.

It is not enough that this patient becomes intellectually aware of all that I’ve described.

For therapy of this kind to be successful, she will have to feel it, not just know it.

Feel it intensely.

Why?

Early life is a “hot” moment in virtually any life. Emotions are highly charged in children. We have not yet learned how to regulate those feelings, and so we are very, very vulnerable to injury. Nor do we have any of the defenses or the intellectual understanding of things and of people that will help us later to navigate the choppy waters of life.

And so, in this “hot” and challenging early time in our existence, we begin to formulate solutions to the difficulties of life.

For example, if voicing opinions different from dad’s beliefs results in his condemnation, many kids will learn to keep their mouths shut and internalize their feelings. Meanwhile, they are likely to feel diminished and less good about themselves if there is too little love and too much criticism.

A parent’s opinion counts enormously in the formation of the child’s self-image.

Time passes and the child perhaps has succeeded in reducing, at least a little, the amount of displeasure, anger, and targeted discontent coming from his mom or dad. So the behavior of keeping a low profile and “acting the part” that the parents expect is reinforced, even though depression and self-loathing are below the surface.

Such choices are made by the child unconsciously, but seem to make the best of a bad situation and become a well-ingrained pattern of behavior.

Eventually the child becomes a teen and soon a young adult, away from a good portion of the daily parental disapproval. Now, having established some defenses and skill in handling life, the crackling tension of early childhood is over. Instead of the ever-present hot moments of early life, existence now consists mostly of many more “cool” moments in which the pattern of behavior becomes solidified and habitual.

Think of it this way. A small child is like a piece of metal in a forge or foundry. The searing affective cauldron of early life is like the super-heated nature of a forge, designed to make the metal malleable so that it can be wrought or cast. Unfortunately, in the childhoods I’ve been describing, the little piece of metal that is this tiny life is shaped by the destructive forces of the household into a form that is warped; not fully serviceable.

With the passage of time and the “cooling down” of the emotional intensity of that life, the newly shaped adult — like the forged or cast piece of metal — is no longer malleable. The pattern and outline he or she is now in — the self-opinions and self-defenses that were established in the forge — have taken on a permanent, fixed form. The same ways of living developed while young continue to be used to some extent, even if they are not all that useful; even if conditions have changed.

Obviously, new learning is still possible, but at the deepest level — the level of self concept and self-love, as well as the tendency to be drawn to certain kinds of people when looking for love — alteration of the shape or form or way of living is much harder to achieve.

What then does therapy do to assist with this much-needed alteration?

The therapist and patient work together to re-enter the “forge” of childhood, that time of “hot” moments when personality was fashioned into its current image.

Once back in the foundry, the emotion generated in recollecting that time can make one malleable again: capable of being reshaped and of reshaping oneself into a less self-critical person who believes in his value and no longer seems so drawn to people who are excessively critical.

Therapists who do this kind of “depth” or “psychodynamic” psychotherapy may well encourage the patient to journal — even to write autobiographical essays. They can be assisted in remembering what seem like incidental details of early life such as their school teachers, the friend who sat next to them in third grade, the path they took to walk home, what TV shows they watched, the time of day that mom or dad came home, the summer vacations that were taken, the sounds present in the home, the aroma of cooked foods, and so forth.

Anything that might be useful to jog emotion and memory is fair game, including old photos and report cards, conversations with siblings or childhood friends, and revisiting the neighborhood in which one was raised.

The process can be painfully difficult. Indeed, it must generate significant emotion to reproduce, as far as possible, the forge-like nature of early life — the conditions which permit a realignment of internal interpretations, understanding, and feelings. Grieving over the losses of the past can only come with openness to whatever is felt and discovered in digging up the psychic “can of worms” that sometimes is to be found in one’s past.

And it is the emotion connected to the early trauma that, when finally re-experienced to at least a partial degree, proves cathartic and informative; allows one to realize that “it wasn’t your fault;” at least not to the disqualifying extent that you have come to believe it.

Sometimes there is a “break through” moment, as in the film Good Will Hunting with Matt Damon and Robin Williams. But even without that kind of emotionally generated epiphany, this type of treatment can be transformative.

Of course, not everyone needs to do this. A more cognitive behavioral approach along side this type of exploration may also be helpful in some cases.

But sometimes there is simply no substitute for the hands-in-the-dirt and feet-to-the-fire process that I’ve described.

Take heart.

If your therapist wants to talk to you about your childhood, sometimes it might just be exactly what you need; just exactly the cauterizing instrument that your hurt is waiting for.

Remember — the heat of the forge can be hard to withstand, but upon emerging from it perhaps you will notice that its warmth has healed your lonely heart.

—

The above image is Metallurgist working by the blast furnaces in Třinec Iron and Steel Works courtesy of Třinecké železárny, sourced from Wikimedia Commons.

June 25, 2009

Anger Anyone?

Some of the very logical or morally upright folks out there believe that you should never get angry. Never ever.

I’m not one of those folks. First of all, we are all human, and to be human means to have emotions. Second, it is hard to imagine a humanity capable of defending itself, the spouse, and the kids, who can’t get in touch with some needed anger when we or our loved one’s are imperiled.

When danger appears, we are built to fight or flee. The sympathetic nervous system readies you for action. Adrenaline starts to pump, the big muscles of our body receive more blood as the heart rate increases, breathing becomes more rapid, the pupils widen (the better to see danger, my dear!), and sweat gland activity heightens to keep you cool in the event of a major exertion of energy (as well as to make you slippery, so that an aggressor can’t get a firm grip on you).

All of this has been “selected for” in the Darwinian sense: if our ancestors hadn’t successfully fled the tiger or defeated the enemy with the help of these physiological changes, we’d not be here and their genetic line would have stopped.

The same logic suggests that the female of the species historically tended to choose males who were capable of defending her and the kiddies, especially when pregnancy and child-rearing made them particularly vulnerable. But, since the female couldn’t always depend upon the male when he was out hunting and gathering, she needed some anger too.

So, if you get angry, as you almost certainly do, you have come by at least some of it honestly and through no particular effort of your own.

That said, how do you know when your anger goes over the top? Some people will tell you when that happens, of course, and sometimes the authorities will in the form of police. If you are no longer a child and get into fist fights or find yourself yelling a lot, you’ve almost certainly got a problem, either as an aggressor or as a victim. Alcohol might add to your combustibility since it tends to disinhibit people, making big emotions more likely. For some otherwise mild mannered men and women, drinking turns them to the dark side. As the old Chinese saying goes, “first the man takes the drink, then the drink takes the man.” Substitute the word “anger” for the word “drink” and you have an equally valid way of looking at anger. Do you have the anger, or does the anger have you?

On the subject of old sayings, there is an Italian saying that also applies to this issue: “If you want revenge, you should dig two graves.” This means, of course, that revenge is likely to consume you (and perhaps even lead to your demise) just as much as it is likely to succeed in hurting the other party. Lives have been eaten-up and made perpetually miserable by the preoccupation with righting wrongs. Think of the centuries long enmity that exists in the Balkans or the long standing animosity between the Greeks and the Turks. Numerous other examples could be cited. One act of revenge causes the victim to look for his own revenge and back again in a circle without end.

Anger is often the result of a real injury, but the danger is in becoming the thing that you learn to hate because of that injury. The data on the likelihood of child abuse being perpetrated by parents who were themselves abused  is fairly well known. Such a parent is much more likely to abuse his children than a parent who was not himself abused as a child. When I tell people this they often find it puzzling. Surely, they say, the abused child would learn what not to do from the parent’s bad example. But think of cigarette smoking or drug/alcohol abuse. Again, the child raised by an addicted mom or dad is at greater risk of duplicating the parent’s behavior than one raised by parents who are abstinent. Not only does the child have the model of the parent as a bad example in these homes, but, in the case of abuse, the youngster has to deal with the anger and hurt inside of him, which comes from being targeted. As children these kids can rarely succeed in retaliating against their parents, but they can take their feelings out against other smaller children (including their siblings) or against their own helpless children when they have become adults. Indeed, unless the abused child is able to obtain relief from the feelings of anger and sadness that come with abuse (and this usually takes therapeutic intervention), he is likely to carry some of these emotions and their behavioral consequences into adulthood. A good book on the subject is For Your Own Good by Alice Miller. A first class movie that depicts exactly what I’ve described is Good Will Hunting.

Back to the question of how you might know whether you have an anger problem, there are a few additional indicators. Do you (or do people tell you) that you react out of proportion to events that are not seen by others as being that big? Do you find yourself feeling angry or irritable much of the time, or awakened by resentments in the middle of the night? Do you have road rage? Have you every punched a wall or thrown an object due to this sort of upset? If you are an athlete in a contact sport, do you enjoy inflicting pain on the opposition?

Even if none of the above apply, there might be other ways that you express your resentment. Do you intentionally delay or put off tasks that others (a spouse or a boss) want you to do, but you don’t believe are that important? Are you sarcastic to others, rather than direct? Do you grumble in discontent or talk behind the back of others at what they’ve done (or not done) or complain about their personal qualities, but put a friendly face on in front of them? If you’ve answered “yes” to some of these questions, you might just be “passive aggressive,” expressing your ire indirectly.

Again, I’m not saying that all anger is inappropriate. And, certainly, one shouldn’t always turn the other cheek, lest one regularly get taken advantage of. But anger can be a problem for you and for those around you. Like a big dog, it should be kept on a short leash. If you can’t manage that, think about counseling.

A recent review article in The Behavior Therapist by Kulesza and Copeland concludes that cognitive behavior therapy is the current treatment of choice for anger problems. The authors emphasize the need for both training in behavioral skills and the use of cognitive restructuring to insure the best results. Therapy for anger issues is therefore likely to include direct instruction about antagonism and its management; self-monitoring of angry feelings, thoughts, and behaviors; relaxation training; assistance in new ways of thinking about the events that trigger rage episodes; social skills/assertiveness training; direction as to how to think about and undercut anger when it does occur; and practice in being exposed to triggering events so that new skills can be employed and the patient can learn to tolerate or diffuse the emotional intensity and stop short of vehement outbursts.

Among self-help books, one of the best is Stop the Anger Now: A Workbook for the Prevention, Containment, and Resolution of Anger by Ronald Potter-Efron.